=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851438576
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER A. BASSOLINO PHARMACY CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2007
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1262 MADISON AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10128-0516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-289-9168
-----------------------------------------------------
Fax | 212-427-3320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1262 MADISON AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10128-0516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-289-9168
-----------------------------------------------------
Fax | 212-427-3320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERVISING PHARMACIST
-----------------------------------------------------
Name | MR. CHRISTOPHER A BASSOLINO
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 212-289-9168
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 020550
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------